Provider Demographics
NPI:1720952088
Name:RILEY, SHARNETT TESHENA
Entity type:Individual
Prefix:
First Name:SHARNETT
Middle Name:TESHENA
Last Name:RILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ROUTE 134 STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-3430
Mailing Address - Country:US
Mailing Address - Phone:508-398-0133
Mailing Address - Fax:508-394-4412
Practice Address - Street 1:500 ROUTE 134 STE 2
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-3430
Practice Address - Country:US
Practice Address - Phone:508-398-0133
Practice Address - Fax:508-394-4412
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1002553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist